fibrin and Lichen-Planus

This retrospective study performed to investigate direct immunofluorescence (DIF) findings in oral and cutaneous lichen planus (LP), and to identify any differences between them. There were 147 patients with a definite diagnosis of LP by clinical and histological criteria, with 87 (59.2%) oral and 60 (40.8%) cutaneous specimens. Of these, 125 (85%) had positive DIF findings, with positive yields being significantly lower in oral (79.3%) than in cutaneous (93.3%) LP. Deposition of immunoreactants at the dermoepidermal junction (DEJ) was significantly greater in oral than in cutaneous LP, and fibrin deposition with shaggy pattern at the DEJ was also significantly greater in oral than in cutaneous LP. Deposition of immunoreactants at colloid bodies (CBs) with or without DEJ was significantly greater in cutaneous than in oral LP. IgM deposition at CBs was commonly detected in both groups. We propose that fibrin deposition with shaggy pattern at the DEJ is the best diagnostic indicator of oral LP.

Topics: Adult; Female; Fibrin; Fluorescent Antibody Technique, Direct; Humans; Immunoglobulin M; Lichen Planus; Lichen Planus, Oral; Male; Middle Aged; Retrospective Studies; Skin

Direct immunofluorescence (DIF) studies in patients with lichen planus (LP) show the deposition of multiple immunoglobulins (Igs) at the cytoid bodies (CBs) and fibrin at the dermoepidermal junction (DEJ). The deposition of Ig at the DEJ, as in patients with lupus erythematosus (LE), is occasionally found. For cases with no specific clinical and histologic characteristics, or with ambiguous features, DIF studies may be helpful in disease differentiation.. From 1996 to 2004, data from 72 patients with LP, diagnosed on the basis of clinical and histologic criteria at the Department of Dermatology, Siriraj Hospital, Bangkok, Thailand, were collected. The results of DIF studies were analyzed.. Deposits at the DEJ and CBs were detected in 53% and 60% of cases, respectively. A combination of DEJ (mostly fibrin) and CB (mostly IgM) deposits was found in 38% of cases. A combination of IgM and other immunoreactant deposits, including fibrin at the CBs, was found in 56% of cases.. This study showed that the positive yield of DIF in LP was 75%. Shaggy fibrin deposition at the DEJ, which is the single best indicator in the diagnosis of LP, was found in 56% of cases. The presence of CBs only, which is a poorer indicator than the shaggy deposition of fibrin along the DEJ, was found in 22% of cases. There were no statistically significant differences in positive DIF yield between specimens derived from glabrous skin and oral lesions (P = 0.67). Forty-four per cent of cases had immunoreactants other than fibrin deposited along the DEJ, which resembled those of LE.

Topics: Adolescent; Adult; Aged; Child; Complement C3; Female; Fibrin; Fluorescent Antibody Technique, Direct; Humans; Immunoglobulins; Lichen Planus; Lichen Planus, Oral; Male; Middle Aged; Mouth Mucosa; Skin

A 23-year-old Italian woman presented with asymptomatic, symmetric, hyperpigmented patches on her face. The dermatosis became exacerbated in summer and closely resembled melasma. The histologic examination and immunofluorescence studies revealed typical features of lichen planus. Actinic lichen planus mimicking melasma is a rare dermatosis occurring mostly in women of oriental origin. The differential diagnosis of further facial melanoses will be discussed.

Topics: Adult; Diagnosis, Differential; Facial Dermatoses; Female; Fibrin; Fluorescent Antibody Technique, Direct; Humans; Hyperpigmentation; Hyperplasia; Immunoglobulin A; Immunoglobulin M; Keratinocytes; Keratosis; Lichen Planus; Lymphocytes; Melanosis

We have studied 10 cases of scarring alopecia, and investigated the diagnostic reliability of immunofluorescence and histopathology in lichen planopilaris and pseudopelade. In the light of our findings, we discuss the possible pathomechanisms of both disease processes.

Topics: Adult; Alopecia; Child; Child, Preschool; Female; Fibrin; Fluorescent Antibody Technique; Humans; Lichen Planus; Male; Middle Aged; Scalp

Lichen planopilaris is believed to be a variant of lichen planus because both diseases have similar histologic features. However, as the clinical features of the two diseases differ, we conducted immunofluorescence studies to examine the relation between the two conditions more closely.. Direct immunofluorescence was performed on scalp lesions of seven patients with lichen planopilaris. All had abnormal linear deposits of Ig restricted to the basement membrane zone of hair follicles. The deposits consisted of only IgG or IgA in five patients (70%) and of IgG in combination with other Igs in two patients (30%). Basement membrane zone deposits of fibrin were present in only one patient (14%) and were linear in appearance. There was no staining of ovoid bodies. These immunofluorescence abnormalities differ from those associated with lichen planus where basement membrane zone deposits of fibrin are present in almost all patients, where the basement membrane zone deposits are fibrillar in appearance, and where the deposits of Ig over ovoid bodies are common.. The different appearance and composition of abnormal deposits of immunoreactants in lichen planopilaris and lichen planus suggest that the two conditions are different diseases.

Topics: Adult; Basement Membrane; Female; Fibrin; Fluorescent Antibody Technique; Humans; Immunoglobulins; Lichen Planus; Male; Middle Aged; Scalp Dermatoses; Skin

Immunofluorescence (IFL) examination in lichen planus (LP) often reveals fibrin deposition in the basement membrane (BM) zone and colloid bodies (CB) giving a positive IgM fluorescence. Oral biopsies were taken from the involved buccal mucosa of 10 LP patients. IFL examination showed fibrin deposition in the BM area of all patients but in none of the seven controls. CB were found in the upper connective tissue of 5/10 oral and 3/3 skin specimens and they were always positive for fibrin, IgM and keratin. Positive staining with keratin antiserum suggests the epithelial origin of CB but the importance of fibrin and IgM staining remains unknown. Double IFL staining revealed that in areas of heavy fibrin deposition and CB formation the laminin and fibronectin staining was absent, suggesting a damage to BM. Moreover, IFL examinations with serum amyloid P (SAP) antiserum and basic fuchsin (BF) showed alterations indicating that upper connective tissue elastic fiber system is also involved in oral LP.

Topics: Colloids; Complement System Proteins; Female; Fibrin; Fibronectins; Fluorescent Antibody Technique; Humans; Immunoglobulin A; Immunoglobulin G; Immunoglobulin M; Laminin; Lichen Planus; Male; Mouth Diseases

Direct immunofluorescent staining (DIF) was performed on biopsy specimens from thirty-five patients with oral lichen planus. The results showed fibrin deposition in all cases at the mucosal-submucosal interface, within colloid bodies (fourteen of thirty-five) and within vascular walls (five of thirty-five). Deposition of IgG, IgA and IgM was detected to a lesser extent, while complement (C3) could not be identified in any case. The significance of these findings was assessed by comparison with the IF results obtained in thirty-five biopsies from various oral diseases other than lichen planus and ten healty persons. Although the presence of fibrin deposition at the mucosal-submucosal junction, within vessels and cytoid bodies, was found to be highly characteristic of lichen planus, these findings were not specifically diagnostic. Morphologically identical deposits were also seen in lupus erythematosus. It is known at present whether immunologic reactions may play a role in the pathogenesis of lichen planus. However, the immunopathologic findings may occasionally be additional suggestive markers in the diagnosis of the disease.

Topics: Complement C3; Female; Fibrin; Fluorescent Antibody Technique; Humans; Immunoglobulin A; Immunoglobulin G; Immunoglobulin M; Lichen Planus; Male; Middle Aged; Mouth Diseases

Solar keratoses (SKs) may show basal cell liquefactive degeneration (BLD) and, when extensive, this can result in a superficial resemblance to lichen planus. The frequency of these phenomena and involvement of immune mechanisms in them have been investigated in this study. The prevalence of lichenoid keratosis (LK) was 6.1% in 212 SKs examined retrospectively and 10.7% in 28 examined prospectively. Histologic features were scored on analogue scales and their interrelationships examined. BLD could not be correlated with epidermal atypia, acanthosis, acantholysis, or inflammatory cellular infiltrate; a negative correlation occurred with parakeratosis. Immunoglobulins and/or fibrin and complement were found by immunofluorescence in 78.8% of the 28 specimens examined prospectively. Three LKs showed similar immunofluorescence findings to ordinary SKs. No circulating antibodies to epidermal structures were detected in patients with SKs. It is concluded that (1) no feature of SKs investigated predisposed to lichenoid change, (2) BLD was a frequent feature in SKs whereas full development of LK occurred much less frequently, and (3) immunoprotein deposits were not related to the development of BLD. Clinically, LKs could not be distinguished from ordinary SKs.

Topics: Fibrin; Humans; Immunoglobulins; Keratosis; Lichen Planus; Prospective Studies; Retrospective Studies

Twenty-seven patients (19 females and 8 males) with a clinically diagnosed desquamative gingivitis were used in this study. Twenty-seven additional patients with oral and skin diseases and with gingival involvement other than that of the desquamative gingivitis type served as controls. Biopsy gingival specimens were sectioned and stained with H and E. The rest of the tissue specimen was cut with a cryostat and used for immunofluorescent assays of the tissue-bound antibodies (IgG, IgA, IgM, C3 anf fibrin). Circulating antibodies were determined by using the indirect immunofluorescence method in serum samples. Normal human oral mucosa and several animal epithelial tissues were used as substrates. The immunopathologic findings suggest the diagnosis of lichen planus in the presence of linear or granular fibrin deposition at the basement membrane zone/mucosal submucosal interface with or without cytoid bodies and cicatricial pemphigoid, in the presence of circulating and/or tissue-bound immunoglobulins and C3 in a linear continuous pattern along the BMZ. It is suggested that an accurate diagnosis of the underlying disease of the desquamative gingivitis can be made on the bases of the clinical, histopathologic, immunopathologic and follow-up findings.

Topics: Adult; Aged; Complement C3; Female; Fibrin; Fluorescent Antibody Technique; Gingival Diseases; Gingivitis; Humans; Immunoglobulin A; Immunoglobulin G; Immunoglobulin M; Lichen Planus; Male; Middle Aged; Pemphigoid, Benign Mucous Membrane

Fibrinoid necrosis which in previous investigations was demonstrated in the epithelial cells of the skin and of the liver in certain disorders, may also appear in the colloid bodies in lichen planus. Trichrome stainings were positive for fibrinoid, staining reactions with haematoxylin variants indicated the presence of keratin and precursors, and investigations in Wood's light permitted conclusions concerning the appearance of mixed proteins, of which keratofibrinoid seems to be the most important. Circulatory disturbances are emphasized as having an important role. The colloid bodies are extruded from the epidermis, according to the observations of Kerr et al., following the rules of apoptosis.

Topics: Epidermis; Epithelium; Fibrin; Histocytochemistry; Humans; Keratins; Lichen Planus; Microscopy, Fluorescence; Necrosis; Paraproteins; Staining and Labeling

To demonstrate the exact localization of immunoglobulin and fibrin deposits in skin lesions of lichen planus, we employed the peroxidase-antiperoxidase technique, both light and electron microscopically. IgM is shown to be deposited preferentially in and on the cytoid bodies all over their cut surface in a typical stippled pattern, partly obscuring the characteristic fibrillar substructure. All other structures such as the basal lamina are devoid of IgM deposits. Fibrin (F) is also present in cytoid bodies but in a lesser amount; it is characteristically deposited on and along the basal lamina and its reduplications in the uppermost strata of the dermis. Our results indicate that IgM deposition in cytoid bodies occurs at a very early stage during the formation of these structures and that fibrinogen exhibits a specific affinity not only to cytoid bodies but also to basal lamina material.

Topics: Fibrin; Fluorescent Antibody Technique; Humans; Immunoenzyme Techniques; Immunoglobulin M; Lichen Planus; Skin

Direct immunofluorescent (IF) staining was performed on biopsy specimens from fifty-three patients with active lichen planus. In fifteen of these cases uninvolved skin sites were also examined. Globular or cytoid body-like deposits of immunoglobulins, mainly IgM, were detected in forty-six of the active lesions, and in half the uninvolved skin biopsies. The deposition of fibrin in the papillary dermis and around follicular structures was seen only in the active lichen planus papules. The significance of these findings was assessed by comparison with the IF results obtained in 252 biopsies from various cutaneous disorders, stained by the same technique during the period of this study. Although the presence of immunoglobulin cytoid bodies and fibrin was found to be highly characteristic of lichen planus, these findings were not specifically diagnostic. Morphologically identical deposits were seen not infrequently in lupus erythematosus and in eczema. Active lesions of dermatitis herpetiformis, erythema multiforme and other rare dermatoses also showed these cytoid body-like immunoglobulin deposits.

Topics: Fibrin; Humans; Immunoglobulin M; Immunoglobulins; Lichen Planus; Lupus Erythematosus, Systemic; Skin

Topics: Fibrin; Histocytochemistry; Humans; Immunoglobulins; Lichen Planus; Macrophages

Topics: Animals; Antibodies; Biopsy; Capillaries; Complement System Proteins; Female; Fibrin; Fluorescent Antibody Technique; Humans; Immunoglobulin A; Immunoglobulin G; Immunoglobulin M; Lichen Planus; Male; Rabbits; Skin

Topics: Animals; Biopsy; Chemical Phenomena; Chemistry; Fibrin; Fibrinogen; Fluorescent Antibody Technique; gamma-Globulins; Histocytochemistry; Humans; Lichen Planus; Methods; Microscopy, Fluorescence; Peroxidases; Rabbits; Skin

Topics: Aged; Biopsy; Diagnosis, Differential; Erythema Multiforme; Female; Fibrin; Fibrinogen; Humans; Leukoplakia; Lichen Planus; Male; Microscopy, Fluorescence; Microtomy; Mouth Diseases; Mouth Mucosa; Pemphigus; Staining and Labeling

Topics: Complement System Proteins; Fibrin; Histocytochemistry; Humans; Immunoglobulin A; Immunoglobulin G; Immunoglobulin M; Immunoglobulins; Lichen Planus

Topics: Blister; Desmosomes; Edema; Fibrin; Humans; Lichen Planus; Microscopy, Electron

Topics: Adolescent; Adult; Aged; Animals; Antifibrinolytic Agents; Biopsy; Child; Female; Fibrin; Fibrinolysis; Fluorescent Antibody Technique; Humans; Immunoglobulins; Lichen Planus; Lupus Erythematosus, Discoid; Lupus Erythematosus, Systemic; Male; Microscopy, Fluorescence; Middle Aged; Rabbits; Skin

Topics: Basement Membrane; Cell Membrane; Cell Nucleus; Colloids; Desmosomes; Female; Fibrin; Humans; Inclusion Bodies; Keratins; Lichen Planus; Macrophages; Male; Microscopy, Electron; Skin

Topics: Female; Fibrin; Fluorescent Antibody Technique; Humans; Keratins; Lichen Planus; Lysosomes; Male; Microscopy; Microscopy, Electron; Microscopy, Fluorescence; Skin

Topics: Adolescent; Adult; Female; Fibrin; Fibrinogen; Fluorescent Antibody Technique; Humans; Lichen Planus; Male; Middle Aged